Re: Mare diagnosed with EMS/IR
So a couple of things jump out at me. Assuming the pictures you posted of Jamie are current she's not thin. I would say she's at a good weight now and you would not want to see her put much - if any - weight back on. So if she's taping at 1025 that's a better weight to aim for than 1060. You can have a look at the BCS score file for more info on how we judge that but for an IR/PPID horse we prefer to see them about a 4.5 to 5 in condition and she's firmly a 5 to me based on those pictures. (https://ecir.groups.io/g/main/files/Case%20History%20Tools/Tools%20and%20How-To%20Help/Body%20Condition%20Scoring%20Guide.pdf)
With that being said you should hopefully see an improvement with her comfort level as she's on the Timothy Balance cubes. You do want to make sure she doesn't gain weight on them as they are more calorie dense than hay so you may need to adjust the amount fed down (or up) depending on how she does with them. I would suggest planning on retesting her insulin within 3 weeks of the diet change and have a TRH stim test done at that time for her ACTH as she may well be early PPID and that could be contributing to her elevated insulin. If that comes back with a positive result she would need to be on Prascend but you can put her on APF (that's covered in the welcome letter) before starting it and titrate her up to the full dose as you already know she'll have a veil effect if given a full dose right away.
IF she's not showing improved comfort with the diet change she'd be a candidate for metformin but I'd want to check her ACTH first as she's a QH and when they present with IR it's usually due to PPID.
Oh, one last thing - if you want assistance on her trim please post a note for Lavinia with a title of "Lavinia, markups needed" and make sure you have all the photos and views requested here: https://ecir.groups.io/g/main/wiki/1482#Photos-and-Hoof-Evaluation-Help in her photo album.